Inspection on 27/04/07 for Manor House

This inspection was carried out on 27th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Manor House 03/11/05

Manor House 16/05/05

Manor House 10/08/04

Manor House 11/05/04

Manor House 21/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Manor House London Road Morden Surrey SM4 5QT Lead Inspector Emma Dove Unannounced Inspection 27th April and 30th and 31st May 2007 12:40 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor House Address London Road Morden Surrey SM4 5QT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 648 3571 F/P 0208 648 3571 manorhouse@totalserve.co.uk Mr Dudley Sessford Mrs Helene Sessford Mrs Helene Sessford Care Home 23 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (23) of places Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Manor House is a registered care home for up to twenty-three elderly people, ten of whom may have dementia. Twenty-two people are currently living there. Manor House is a small family run business with one of the owners managing the home. Accommodation is provided over two floors of a detached property. A lounge, conservatory, smoking lounge, dining room, kitchen, laundry room, bathroom and toilets and some bedrooms are on the ground floor. Further bedrooms and bathrooms are on the first floor. All bedrooms have ensuite facilities. A lift serves the ground and first floor. Residents have access to a large garden. Manor House is situated within a residential area of Morden. Parking is to the side of the home. Public transport bus services are within a short distance of the home. Information about the CSCI is available at the home. The current fees are from £485 to £500 per week depending on whether it is a single or double room. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours on the 27th April, three hours on the 30th May and four hours on the 31st May 2007. One inspector visited the home and spoke with residents, staff the deputy and the manager. Records were looked at and the communal areas and six bedrooms were seen. Questionnaires were sent to relatives, health professionals and placing social workers. One questionnaire has been received by the CSCI and comments are included in the relevant sections in this report. What the service does well: What has improved since the last inspection? What they could do better: Update Statement of Purpose to acknowledge that respite care is provided. The provision of a few more activities would improve the service for some people. Check the garden path following comments from two people that the path is uneven. Staff files must contain evidence that full checks have been made prior to staff starting work. The fire alarm must be tested weekly for safety reasons. The lift must be serviced as required with copies of work completed available. Records of residents finances must be up to date and the balance correct. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service understands the importance of having sufficient information when choosing a care home. It has developed clear information to help people understand what services are provided. Admissions are not made until a full assessment has been completed. EVIDENCE: The Statement of Purpose and Service Users Guide are in place and include information about the services provided, to help people decide whether to move in. This document must be updated to reflect that the home offers respite care can be offered. One resident said that they had been unable to visit prior to admission but their relative had visited and decided it was the right place. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 9 One relative reported that they had not received information about the service prior to admission. Assessments are completed prior to admission both by the manager or deputy and placing social worker if required. Assessments include information about peoples need and the support they require, so that needs can be met. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every person has a care plan which includes information to deliver care. Health needs are well recorded with clear details of actions taken to ensure people are well. Personal support is responsive to individual’s needs and preferences. Staff respect peoples privacy and dignity. An efficient medication policy is supported by procedures and practice. Medication records are fully completed and contain the required entries and are signed by staff. EVIDENCE: Case files contain individualised information about peoples’ social history, hobbies and medication. Care plans have been developed with each person and include information from assessments. Care plans are reviewed monthly and updated if peoples needs change. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 11 The monitoring of peoples weight is sporadic with some details taken monthly and others every few months. If there are concerns about peoples weight, regular monitoring should be carried out to ensure their needs are met. Risk assessments are in place and note potential issues and how staff should respond to ensure peoples safety is maintained. Staff were heard saying ‘good girl’ and using other names such as ‘darling’ when speaking with residents. This was not seen as a problem by residents and at other times residents said things like ‘the staff are darlings’. This practice was discussed with the manager and should be raised with residents but was felt to be a part of the homely culture. Medication is administered from a monitored dosage system, records are up to date and signed by staff. Medication is securely stored and appropriate records are kept of controlled medications. Records indicated that one person regularly refuses medication, this has been discussed with the doctor and is noted in the care plan. Excess medication should be returned to the pharmacy. Residents made positive comments about the care and support they receive, with comments including ‘I like it here’ and ‘staff are helpful’. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have access to a few regular planned activities and outings and are able to maintain links with the local community. Visitors are welcome. Mealtimes are well managed social occasions and peoples dietary needs are recorded and met. EVIDENCE: Residents opinions about the type of activities available varied from ‘I like to join in with Bingo and the quiz’ to ‘I don’t join in much’ and ‘I keep to myself’. People were seen to be watching television, talking with staff, spending time with visitors, going out with visitors, reading the paper, painting flower pots and knitting. Some people said that the provision of a few more activities would improve the services. A member of staff is employed for two and a half hours, five days a week to provide activities and social opportunities for people. The person who had been covering this post recently left and a number of residents commented Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 13 that they missed them and were looking forward to new staff taking over the position. Visitors are welcome and are offered drinks and are able to visit in communal areas or in private in the persons bedroom. Lunch and an evening meal, were seen to be well managed with people offered a choice, given time to eat their meal before plates were cleared away. People made positive comments about the food including ‘I like the food’, ‘lunch was good’, ‘I like the ‘high tea’ and ‘they give me what I like to eat’. One comment received from a relative indicated that meals are of different quality when the cook is off. The cook reported that meals are usually prepared in advance and a replacement cook covers on her days off. The cook has been in post for a number of years and is aware of peoples’ dietary needs and likes and dislikes. Residents have a choice of cereals, porridge, toast or eggs for breakfast, a hot meal is provided at lunchtime and a lighter meal at 5.30pm. Two evenings a week people have ‘high tea’ in the lounge, which is sandwiches and cake, this was reported to be a favourite by residents and staff. Wine is served with Sunday lunch and some people have a supply of wine, sherry or whisky to have with their meals or in the evening. The carpet in the hall was cleaned during one mealtime and this practice should be reviewed as it is noisy and may interrupt people while they are eating. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A complaints procedure is in place and available to residents and their representatives. People are aware of how to make a complaint. Policies are in place to protect people from harm, however records of peoples finances are not up to date. EVIDENCE: The complaints procedure is available to residents and their representatives. Records indicated that one complaint has been received since the last inspection, which is being addressed and the manager is responding to. People had no concerns about the care that they receive. A policy is in place for the protection of vulnerable adults, this requires updating to inform social services if an allegation is made. Some money is held for some residents. Records showed that two balances were not correct and up to date, both had more money than the record indicated. Records must be up to date for transactions made to ensure residents money is managed appropriately. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are encouraged to personalise their bedrooms. Bathrooms and toilets have appropriate aids and adaptations to meet peoples needs. The home is clean, tidy and generally smells fresh. EVIDENCE: There is a small lounge/library/computer room for residents who smoke, a through lounge with doors to the garden, lounge and conservatory with doors to the garden. A separate dining room is also provided. The communal areas are homely and offer a selection of comfortable chairs, side tables and footstools with a television in the lounges. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 16 Two bedrooms are double with nineteen single bedrooms. All bedrooms have an ensuite toilet and wash hand basin. An adapted bathroom is available on the ground and first floor. The laundry room is on the ground floor away from the kitchen and dining room with an additional room on the first floor used for drying clothes. The hairdresser uses a room on the first floor, which is equipped with a sink and hairdryer. A lift provides access to the first floor with two staircases available. A gate is in place at the top and bottom of the main staircase, this was reported to be to protect residents from harm. Peoples comments about the home included ‘I like my room’, ‘I enjoy looking out at the garden’, ‘I’ve got all I need here’ and ‘I’m comfy here and have got all my belongings with me’. Two people commented that the path in the garden is uneven and prevents them from going out or would concern them if they went out. This was discussed with the manager and will be checked. All areas were clean and free from odour with one exception during one visit. The manager reported that an ongoing programme of carpet cleaning is in place, ensuring the communal areas and bedroom carpets are clean. A redecoration schedule is in place which ensures communal areas and bedrooms are kept in good decorative order. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient staff are on duty to meet peoples needs. Staff recruitment practices do not fully protect people from harm. Staff have access to training and support. EVIDENCE: The published staffing rota identified that there are generally three members of staff in the morning and in the afternoon. In addition, the manager or the deputy are available Monday to Friday with an on call system in place for management cover over the weekend and on Bank Holidays. One relative commented that the management cover for the weekends is not sufficient. Ancillary staff are employed to carry out domestic tasks, the cooking and maintenance. Peoples comments about the staff included ‘staff are lovely’, ‘staff give me the help I need’, ‘staff are darlings’ and ‘the staff are ok’. Staff recruitment practices are not fully in line with regulations. Prospective members of staff complete an application form, attend an interview and checks are made before starting work. Four staff files were checked. For two members of staff, two written references had not been received and for one member of staff the references were not from a previous care home, although Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 18 they were from the last employer. One member of staff had not got a Criminal Records Bureau check, although a POVA first check had been completed. It is not clear that gaps in employment are checked. Full employment details were in place for two members of staff, but not for two other staff. Staff files did contain a recent photograph and proof of the individuals identity. Staff reported that they have access to training. Records indicated that some staff have completed training in dementia care, first aid, nail cutting, manual handling, food hygiene, medication administration, infection control, risk assessments and the protection of vulnerable adults. It is recommended that all staff complete training in the protection of vulnerable adults and the care of people with dementia. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the required experience to run the home. Health and safety records are generally good with required checks up to date with the exception of the weekly test of the fire alarm system and the lift service. EVIDENCE: The manager has significant experience working with older people and is committed to running a good homely service for people. Residents meetings are held every six months and staff reported that people are asked: about their likes and dislikes; to raise any issues or concerns; to discuss the menu and activities and are reminded about the fire procedure. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 20 Residents who spoke with the inspector could not remember attending a residents meeting. The deputy reported that questionnaires have been sent out to health professionals and relatives in January and April 2007. One comment received back noted that there is a lot of work for the cleaner. The deputy felt that this wasn’t an issue at this time. Other comments from these questionnaires were positive about the care, support, environments and staff levels provided. The manager reported that most residents have a relative or friend who looks after their finances, with a few people managing their own money. Money for a few residents is looked after, comments regarding this are noted under the complaints and protection section on page 15 of this report. The gas and electrical safety checks were completed in May, February and November 2006. The electrical supply test noted that a full service should be completed in November 2007. The fire alarm system is serviced every three months. The alarm has been tested every month, this test must be completed every week for safety reasons. The lift is serviced every three months, the insurance for the lift notes that a full examination is required in February 2007. This has not been completed and should be actioned to ensure residents are safe when using the lift. Residents and staff reported that the lift had been out of order in April 2007 for three to four days. This was managed by some people using the stairs and other people remaining in their bedrooms for meals and staff spent more time upstairs with residents. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 2 Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Requirement The Statement of Purpose must be updated to reflect the services provided, to ensure people have up to date information and know what to expect. Regular monitoring of peoples weight must be carried out to enable access to information if required. Records of residents finances must be up to date and the balances correct. Staff recruitment practices must include: a Criminal Records Bureau check being completed; two written references must be taken up and gaps in employment must be explored to protect residents from harm. The fire alarm must be tested weekly for safety reasons. The lift must have a full examination as specified in the insurance. Timescale for action 26/07/07 2. OP8 12 (1) a 26/07/07 3. 4. OP18 OP29 17 (2) Sch 4 (9) 19 (4) b 05/07/07 26/07/07 5. 6. OP38 OP38 23 (4) c (iv) 13 (4) 05/07/07 26/07/07 Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP26 Good Practice Recommendations Consideration should be given to the provision of a wider range of activities to meet all peoples needs. Consideration should be given to the times that carpets are cleaned, to ensure that residents are not disturbed while eating their meals. Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Manor House DS0000027225.V343336.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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